ABSTRACT
Objective To investigate the ultrasonographic and clinical pathological features of intrathyroid thymic carcinoma( IT TC) . Methods T he ultrasonographic and clinical pathological features of 11 cases of pathologically confirmed intrathyroid thymic carcinoma were analyzed retrospectively . T he size , shape ,boundary ,internal echo ,calcification ,cystic change ,blood flow of the lesion and lymph nodes of the neck were recorded . T I‐RADS classification was performed on the lesion ,and the medical history ,clinical symptoms and treatment process of the patients were recorded . Results T he lesions of all 11 patients were solid and located in the lower pole or middle‐lower part of the thyroid ,8 cases were located in the right lobe of the thyroid gland ( 8/11 ,72 .7% ) ,and 3 cases were located in the left lobe ( 3/8 ,27 .3% ) . T he maximum diameter diameter of the lesions was ( 3 .55 ± 0 .51 ) cm . All the lesions were hypoechogenicity or marked hypoechogenicity and ill‐defined margin . T he internal echo of the lesions were heterogeneous . Ten lesions were characterized by striped hyperechogenicity interiorly on ultrasonograms . According to T I‐RADS classification ,2 cases were class 4a ,3 cases were class 4b ,2 cases were class 4c and 4 cases were class 5 . T here was no cystic component or calcifcation in all lesions ,and there was no taller‐than‐wide shape . T hree of 11 cases were accompanied by Hashimoto′s thyroiditis . Postoperative pathology showed that 5 cases had cervical lymph node metastasis ,5 had perithyroidal soft tissue in ltration ,of them , 3 cases had recurrent laryngeal nerve ,2 cases invaded the esophageal wall ,and 3 cases invaded the striated muscle of the neck . Immunohistochemistry showed that CD5 and CD117 of all lesions were positive . All patients underwent surgery ,and 3 of them underwent radiotherapy and chemotherapy after surgery . Conclusions There are common sonographic features of intrathyroid thymic carcinoma ,which are located at the lower pole or middle‐lower of the thyroid gland ,presenting a solid hypoechogenicity or marked hypoechogenicity ,with ill‐defined margin and striped hyperechogenicity interiorly on ultrasonograms . T hese sonographic features are helpful for the diagnosis of IT TC .
ABSTRACT
Objective@#To investigate the ultrasonographic features of synchronous and heterochronic liver metastasis in patients with stromal tumors, and to elucidate the value of ultrasonic examination in follow-up surgery.@*Methods@#A total of 1 516 patients with pathologically confirmed gastrointestinal stromal tumors (GISTs) and extra-gastrointestinal stromal tumors (EGISTs) were enrolled. The ultrasonographic features of primary lesions and liver metastases in a total of 46 cases with 95 liver metastases were analyzed.@*Results@#24 out of 46 cases had primary lesion in the small intestine, 14 in the stomach, 4 in the abdominal cavity, 1 in the colon, 2 in the esophagus, and 1 in the mesentery. The expression of CD117, Dog-1 and CD34were detected by immunohistochemical staining. The positive rate of CD117 was 100%, the Dog-1 was 95.7% and the CD34 was 69.6%. There were statistically significant differences in the maximum diameter, boundary and blood flow of primary tumors in 28 patients with synchronous liver metastasis and 18 patients with heterochronic liver metastasis (P=0.001, 0.022 and 0.036, respectively). Of the 95 liver metastases, 86 (90.5%) were located in the right lobe of the liver, 79 (83.2%) had clear boundaries, 75 (78.9%) were hypoechoic or isoechoic, 55 (57.9%) showed colored patterns, and 68 (71.6%) had no halo.11 liver metastases were cystic masses, 59 were solid masses, and 25 were mixed masses. There was a statistically significant difference in blood flow between 65 synchronous hepatic metastases and 30 heterochronic liver metastases (P=0.017).@*Conclusions@#There were differences of the primary tumor ultrasonographic features between the synchronous metastasis group and heterochronic metastasis group. The ultrasonographic features of primary tumors and liver metastases have important clinical significance for the diagnosis, follow-up and treatment of malignant mesenchymal tumors.